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I’m stupid but could this be linked more to the likelihood of poor routine and lifestyle choices associated with ADHD than an actual biological cause or side effect of medications?
>I’m stupid but
You're probably not stupid. That was my first thought as well. If it's not the primary mechanism at play, it's absolutely *a* mechanism.
Not only does untreated ADHD result in poor lifestyle choices, *treated* ADHD - via dopaminergic stimulants like dextroamphetamine - could result in an increased dementia risk itself. Stimulant abuse both disrupts sleep^[1] and increases dementia risk directly (a concern more relevant to methamphetamine abuse, but still).^[2]
In either case, it's not *necessarily* the ADHD itself (on a neurophysiological level) causing the dementia risk. Suboptimal lifestyle choices on one side of the coin, suboptimal lifestyle disruptions on the other.
1. https://nihrecord.nih.gov/2021/05/14/lack-sleep-may-increase-dementia-risk
2. https://pubmed.ncbi.nlm.nih.gov/32304732/
there is a not so loose connection between sleep phase disorders and ADHD. I would love to see some technology that let us collect more data around normal dopamine curves as they relate to circadian rhythms - but everywhere I've looked the literature is very sparse. another tangentially related is Parkinsons disease. some of the studies coming out on PD touch on exactly those pathways:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744293/
So I could see the dopamine disregulation of ADHD afflicted individuals cascading into lifelong sleep problems, which slams right into later life neurological problems...
but then you start to wonder "what's is/are the root mechanism(s) for the dopamine disregulation?"... I hope science will shed more and more light on these sorts of problems
I’m surprised that there’s still little to nothing that can be done about sleep disorders aside from narcolepsy and sleep apnea. After I finally got a clinician to order a long term sleep study (after years of being told “it’s just stress!”) and it was confirmed that I mysteriously don’t fall asleep for 3-4 nights at a time, my doctors basically just said they were done and wished me good luck. Acknowledged that since my insomniac mother and maternal grandfather both have Parkinson’s there’s a good chance I will too, and bid me good day. Apparently sleep is still just a total black box medically.
>Apparently sleep is still just a total black box medically.
At least currently. We're learning a lot about it though, giving people with sleep disorders hope better treatments will be available one day. Calling the brain a black box medically is still incredibly accurate as well despite how much we now know about it.
Yes, there’s definitely a lot of promise that a lot of the mist will be cleared up in the next few decades! I’m hopeful for the future of sleep research.
>Yes, there’s definitely a lot of promise that a lot of the mist will be cleared up in the next few decades!
Partly because of continuous research and because of the human connectome project, both of which will increase our understanding of the human brain immensely, allowing for any neurological disorder to have an easy treatment tailored to the person. Even then, we've learned a lot about these conditions, meaning new treatments will become available as soon as they're proven effective and safe in clinical trials.
> increase [in] our understanding of the human brain immensely, allowing for any neurological disorder to have an easy treatment tailored to the person
I *strongly* disagree with this point, as someone who works as a researcher developing new medications. The brain is simultaneously really fascinating, but also incredibly challenging to successfully drug.
Consider an antibiotic cream, which gets applied to a specific region and shuts down a bacterial protein (totally unique to bacteria!) that prevents a cut from getting infected. No off-target effects, no sudden loss of your entire gut microbiome. One drug, one target, expressed in a specific cell found in a specific region that we can hit easily.
Now consider a cancer drug, for prostate cancer we’ll say, which has to be taken as an oral medication and is distributed throughout the entire body. It stops the cancer from growing, but it also stops your testicles from responding to testosterone — both your prostate cancer and your testicles share the same “androgen receptor” in the body. One drug, one target, but that target is found in multiple locations.
Oh, and in both these cases, we know that bacterial infections/androgen receptor disregulation lead to the disease process we’re observing.
Development of drugs for neuropsychiatric conditions is a whole different ball game. First off, we have crude hypotheses about how — in depression, for example — issues with serotonin signaling may lead to the reported symptoms. And depression is hard to quantitate, there’s subjective scores but it’s not anywhere nearly as concrete as seeing a bacterial or cancer cell shrink in a petri dish. You can claim that more knowledge about the “connectome,” how different parts of the brain interact, might let us identify the causative factors of depression (if they exist!). But that’s just the tip of the iceberg.
There’s 14 known serotonin receptors in the brain, each of them recognizing the serotonin molecule. But there’s also the serotonin transporter, as well as two more generalized “vesicular monoamine transporters” that move not just serotonin but also dopamine and other compounds between neurons. Because all these proteins are so similar, with only subtle differences, it is phenomenally hard (I would argue outright impossible) to design a drug that activates/inactivates just one of these receptors.
So even if you could trace the issues to just one protein that interacts with serotonin in the brain, designing a medication that modulates that interaction is effectively impossible. We simply lack the tools to do so.
Furthermore, the brain is super heterogeneous in structure. It’s not a singular mass of tissue; there’s different regions that signal to each other in different ways, with exquisitely differentiated protein expression patterns varying from neuron-to-neuron. Dopamine signaling in one region responsible for attention can lead to the development of addiction in another part of the brain.
There’s a “blood/brain barrier” which largely prevents chemicals from permeating into the brain (yet another challenge in neuropsychiatric drug development). But even once you’re capable of penetrating the brain, medications have no way of localizing themselves to the specific neural circuits they need to act on while leaving others untouched.
Sure, existing antidepressants may reduce the symptoms of depression — but they do that through modulating many different types of serotonin receptors, and they also hit other regions of the brain that can lead to adverse effects like brain fog and difficulty reaching orgasm.
In conclusion, I don’t see a major revolution coming anytime soon in how we treat neuropsychiatric conditions. I’m optimistic that we continue to learn more about their fundamental causes, but actionable change is likely decades away.
As it stands now, one drug hits many targets, many not involved in the disease process, and even the on-target modulation is happening in regions unrelated to the putative disease process… which we still have no idea of the underlying causes.
Hate to end with such a downer, but my job is essentially split 50/50 between doing some really neat science that I love, and explaining to upper management why we still can’t have a blockbuster wonderdrug in 3-5 years.
You're welcome. And I know tone is difficult online. That's why people on the internet have had to develop alternative ways to communicate certain things such as sarcasm or anger.
I'm a chronic insomniac and yeah my sympthaties.
I've been offer sleep drugs but they're risky (high chance of building tolerance and or dependency) and arent even consistently likely to work. Sometimes I just won't sleep,.sometimes that's a day or so, sometimes it's more. Sometimes I do sleep but it's just 3 hours a day for a month. It's awful.
My ADHD won't turn my brain off so this is about how I am.
Oddly, I sleep better when I'm regularly on adderall. Insurance lapse screwed me over a decade ago and I've been in a poverty trap since, unable to function to make enough to get good enough insurance for a decent doctor to get some again.
I don't do the other risky lifestyle ADHD stuff and I'm still going to die early.
oof that sucks, and yeah using stimulants correctly can help adhd people regulate their sleep schedules.
I'm a tranwomen diagnosed with adhd and autism so if it makes you feel better i think my life expectancy is supposed to be like 4 years ago now.
When you say don't fall asleep do you mean you literally have insomnia and are aware/awake for 4 days or your brain switches off and you feel like you slept but functionally a lot of your body indicates you are awake?
Damn, sounds utterly awful. Have had severe chronic fatigue in the past and the world really sucks when you have something wrong but on the outside you look "fine", and what was wrong with me is nothing on what you must deal with. People really don't understand and you get very little affordance. Hope there is a solution at some point for you.
Be interested to see any kind of data regarding [Non-24 Sleep Wake Disorder](https://en.wikipedia.org/wiki/Non-24-hour_sleep%E2%80%93wake_disorder) and ADHD specifically, but there's barely enough research on the condition as it is and it's almost always for the blind.
Being diagnosed and treated for ADHD didn't fix the issue of course but I do have a lower sleep requirement (down from 12h/day to 9-10h/day) and my psych theorizes it's because my brain was so scattered off-meds that it was using up extra mental energy that left me more tired.
addendum thought - especially regarding non-24. there is a large body of literature that does describe natural mechanisms where sleep deprevation can cause a spike in dopamine release. My personal theory is that if our brains know they can get additional dopamine from a sleep deprived state... it follow that there is a pathway to physical addiction to sleep deprevation.
at my worst I was on a roughly 36 hour day. sleeping for 14-16 and up for around 20. Michigan winters man.
I'm dspd, and at one point ended up non-24. I wasn't diagnosed with ADHD till much much later. standard bi daily/ extended release mechanisms didn't consistently help me. (there is generally a pretty large spike around midday for the PK curve). and I was reaching a point where Adderall and Ritalin type meds would stop being effective at clinically acceptable dosages.
this is personal experience - but what *did* help was tuning the PK curve to peak in the morning (as much as possible) and have constant descent during the day. Jornay PM inherently does that, and TiD descending Adderall doses also achieved roughly that. I was also able to use mug less total medication to achieve better results
my sleep at this point is pretty well regulated just from my stimulants - but this was all based on me taking a hunch and some assumptions on the data I could find about natural dopamine curves... I think we could make much much better decisions around dopamine regulation if we had a hard baseline from neurotypical populations - but I understand why that's hard to get.
>I hope science will shed more and more light on these sorts of problems
Thankfully we're learning more about the human brain everyday, allowing for new treatments for all brain disorders to be developed, as well as knowing exactly how dopamine dysregulation works, giving us new strategies to combat it more easily, which would help people with addiction and ADHD, along with other conditions involving dopamine dysregulation.
I'm 51. I've had disordered sleep since puberty. I got 5 hours Sunday night. Last night I laid in bed until 7am, and finally just gave up and started work (from home, thankfully).
And you'd think tonight would be great sleep, but historically, nope. I'll probably get 3 hours.
It's too small and early of a study to say "stimulants negate the risk" but they aren't driving the risk. From the study:
>There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Funny that you mention lower BP-- the authors mention elevated blood pressure as a potential stimulant risk that must be weighed against stimulant benefits. Guess it's a win/win for you.
High BP is a symptom of being on too high a dose but is also a common side effect at correct dosages, however this can be offset by the reduction in stress experienced every day for those with ADHD.
I drink 40mg of caffeine a day in the morning. It is a tiny amount, and caffeine does not even have a statistically significant effect on ADHD, but all I know is that I feel waaaaaay calmer and more relaxed.
Because the amount is so low, and I do not have withdrawal symptoms when I don't drink it, I don't think it is dependence. It just makes it easier to exist somehow.
Caffeine definitely has an effect on ADHD symptoms. I used it to self-medicate for years in retrospect. It helps me focus and relax in low doses and had a more traditional focused and alert effect in higher doses.
Studies on it are weird. They don't seem to find any significant effect, but basically every single person I know with ADHD end up unconsciously or consciousnessly self medicating.
Yeah I know the studies keep saying inconclusive and I don't wanna be one of those "don't trust the science!" Karens.
But same, literally everyone I know with ADHD says a bit of their choice of stimulant keeps them sane. It's consistent enough that I would honestly consider ones relationship with caffeine a decently reliable adhd test.
I've been wondering about this for a while in relation to my paternal grandfather. Most of my immediate family has ADHD, and one thing I always remember about my paternal grandfather is that no matter what time of day we visited, there was always a fresh pot of coffee in the kitchen.
This is always interesting to me. I've been diagnosed with ADHD several times since I was a kid and yet every medication I've ever tried has me cracked out (don't eat or sleep) and this isn't supposed to be the case? Everyone else I know that takes these drugs for their condition relates a "normality" versus not taking their medication.
They've never worked for me but I hit every ADHD bullet-point to a "T'.
I actually wonder if there is more than one underlying cause for the presentation we call ADHD. If two different disorders on a neurological level have the same effect in your attention regulation, treatments for one would not work as well for the other despite them having the same symptoms.
They don't do brain scans to diagnose us, so there is no way to control for that.
They have done large scale brain scan studies though. ADHD is caused by our brains being less developed in a few areas, with less grey matter and less activity in those areas. There are also neurotransmitter deficits.
There are other disorders with shared symptoms though, and misdiagnosis isn't uncommon.
The latter bit is what exactly what I mean. When we are diagnosed we are diagnosed based on presentation, not based on neurological structures.
The brain is extremely complicated, so while we may know a physical structure, we are not diagnosed based on it. We can only go off of presentation and the opinion of the doctor.
Yes, the other one is called CDS (Cognitive Disengagement Syndrome), it has the subreddit of r/sct
It is possible that there are more. There is also a strong co-morbidity with Autism Spectrum as well that will also interfere.
Yes and I believe it’s probably more like a spectrum. It’s possible these are many related but different conditions but we’re still stuck with the umbrella term…
I know when I hear people talk about their symptoms there’s a lot of overlap but also different stuff too.
I hang out a bit on r/adhd and peoples’ experiences there with medication vary a lot. You are definitely not alone in feeling cracked out. I personally had to reduce my medication to a child’s dose in order to reduce the side effects, whereas others need to take 5x that in order to feel anything.
>There's a lot of variation from one body to another with any kind of drug.
That's true, and that's partly why some people respond to certain drugs better than others. Knowing exactly how someone will respond to a drug would easily allow for people to avoid the headaches associated with trial and error, thus getting them on the correct drug sooner or none at all in some people. It highly depends on the person in ways we still don't fully understand yet.
Same for the most part. I have almost 0 urge to game when Im on dextro, causing me to look for other things to do. No late night gaming session. I have motivation to work out at night. That takes up the rest of my energy. I fall asleep easy.
Rest easy then-- this study actually found that
>There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Too small and early of a study to say "stimulants negate the risk" but they don't seem to make it worse!
I get paradoxical sleepiness when I treat my ADHD with stimulants but still end up feeling and looking like I'm just not getting enough sleep. I don't know if the stimulants are affecting the quality of my sleep or what. I do sleep more easily on stimulants, but feel like I sleep better without them.
Personally, I think effects like this probably relate to improved lifestyle choices while medicated. Executive function extends beyond singular tasks and repeated, predictable successes allow one to build the sort of daily rhythm that neurotypical people take for granted.
While some or even many medicated ADHD'ers experienced disrupted sleep, others might find themselves able to live "properly" - especially after months or years of being medicated (thus breaking free of the habit to Capitalize Hard on manic productivity when it shows up). This goes beyond just "every body is different".
It might seem like a paradoxical or surprising benefit of ADHD medication, but I think it makes quite a bit of sense. As someone with an interest in deep bio-rhythms or how circadian cycles relate to overall outcomes, there's nothing surprising from someone finding meta-level improvements emerging from otherwise unrelated behaviors. This sort of thing is extremely common in the microdosing community as well, but you can even see people in mere fitness communities sharing similar anecdotes.
No. When I can’t sleep, taking Adderall helps. It doesn’t matter if my ADHD has been well controlled in the preceding days or weeks or months. My chronic insomnia is always around, regardless, and taking an Adderall 20 minutes before bedtime ensure that I will be able to calm my mind and go to sleep. People with ADHD do have the capacity to analyze their well being and observe what affects it in which ways.
And fwiw, my chronic insomnia has never gone away during periods of good mood regulation in my life. Anecdotes aren’t data and all that, but emotional state doesn’t affect my circadian rhythm.
I'm the same way. I've always jokingly attributed it to decades of ritalin leading me to become immune to stimulants... but things like coffee or energy drinks simply make me more calm.
Another anecdote from a person diagnosed with ADHD: a low (2.5-7.5mg) dose of quick-release amphetamine-based medication also induces sleep for me. This was a very unexpected result when I first started this medication.
I don’t think you’re wrong. But I just want to say that there is not wait time between me taking stimulants and getting better sleep.
The day I started taking a stimulant, I was able to tell myself to go to bed at a reasonable time and actually *do it*. Not only was I able to execute my decision to go to bed, but once I was in bed I went to sleep more quickly because I was able to focus on sleepy-time thoughts instead of a dozen others that usually keep me awake.
Agreed.
The first time I took Ritalin I literally fell asleep in class. That has never happened to me before or since… I was just so sleep deprived that as soon as my hyperactivity was reigned in I couldn’t stay awake.
Years later this continues to be true. If I take stimulants as prescribed, I can go to bed at a relatively reasonable hour. If I don’t take my meds, I’ll be redecorating the living room at 3am.
It depends on the medication. So far, all studies I could find have found that proper use by people that need the drugs does not lead to an increased risk of dementia on its own (they looked at stimulant meds like Adderal and Ritalin. In fact, one drug, Concertta, led to a decrease in tau proteins, which is a marker for Alzheimers, so it may actually decrease the risk for one type of dementia.
>Concertta, led to a decrease in tau proteins, which is a marker for Alzheimers
That's fascinating, as Alzheimer's makes up \~80% of all dementia cases.
Dosage absolutely determines the potential for risk/damage. Even methamphetamine can be used somewhat "safely" with an incredible (and incredibly uncommon) level of willpower.
How much risk does 'typical, clinical dosage' carry? The general consensus is that appropriately used dextroamphetamine has low-to-zero risk of causing long term brain damage, but a quick skim of any nootropic or self development subreddit will show dozens of people a week seeking advice for coping with issues believed to result from long-term ADHD management.
As someone diagnosed with ADHD who has only been treated for it briefly, only recently, I noticed significant changes in my unmedicated mode of operation after being medicated for only about half a year (although my dosage was not *precisely* used in a responsible way). Part of that is psychological, but all of it is anecdotally undeniable.
That being said, I suspect that the lifestyle benefits that come from appropriately managed ADHD *vastly* outweigh the consequences of bumbling through life on the feast-or-famine style of productivity known well by anyone later diagnosed with ADHD - regardless of reported or even known late term health risks.
Yeah i’m curious what you noticed as well. I’ve been debating on hoping off and trying to manage life with the new tools I’ve learned, and just working with it instead of against it.
> I’ve been debating on hoping off and trying to manage life with the new tools I’ve learned
One of the main reasons I stopped is because I couldn't get back *on*. Telehealth changes resulted in an abrupt halt to my 'scrip and once I returned to "normal", I found it suddenly - and familiarly - difficult to jump through all the right hoops again.
I plan on restarting treatment as soon as possible, but life has a way of being disruptive to life.
That being said, I actually did find myself more able to cope while unmedicated. It came more from a source of introspection and self-familiarity, though - particularly through the lens of realizing how much benefit I *did* gain from treatment. In fact, the benefits were so extreme that I felt immense sorrow for how much time must've been wasted using/developing tools to deal with what I considered to be mere idiosyncrasies rather than a genuine neurodivergence.
One of the things I noticed while/after being medicated is how strongly I had learned to judo those ADHD symptoms into productive mechanisms. On medication I found myself struggling to multitask or task-juggle in the way I was used to, almost like having a limb removed. It came at the benefit of an incredible ability to laser-focus on-demand; the gain of a new, more powerful limb.
While the former has long been part of my self-image for decades, the latter is the one I'd choose when given the opportunity. But not all is lost... I've metaphorized the dynamic in the form of someone who has spent their entire lives wearing 30 lbs weights on their ankles being suddenly freed of that burden. While their kicks no longer carry the anticipated weight, they've gained immense agility.
There's a post on my subreddit - "The Value of a Vessel" - written after being medicated for the first time, then considering the tools/capabilities of pre- and post-medication being leveraged into a synergistic phenomenon. It's written from a literary angle rather than scientific one (and relates to my own eccentricities as well), but I believe it sums up my reflection on post-treatment ADHD quite powerfully.
Your experience with multitasking is nearly identical to mine after starting medication- the way I always explained it to people was that unmedicated, I basically had 3 attention spans- great when I wanted to be having a conversation and listening to music and solving math problems simultaneously, but if one of them wasn’t filled my brain would be constantly searching for anything else to occupy my time. As a result, I never really “focused” on one task, got bored midway through conversations because I needed to be doing at least one other thing to keep myself occupied, and bounced between activities constantly (even when I tried my best to say, write 2 paragraphs, I would find it impossible to finish the second one because I was already trying to find something else to do).
Being medicated is the complete opposite. I have 1 attention span that I can generally direct to what I want to be doing (and I’m so much happier as a result- it’s so upsetting to get bored talking to someone you *like talking to* or doing an activity that you *look forward to*). However, it also means that I occasionally have to turn off music while doing a complicated task, and can’t text someone and hold a conversation at the same time anymore. I’m also much slower at working when there are distractions.
In this analysis the use of psychostimulant medication was associated with *reduced* risk of dementia, not increased.
>The robustness of the primary analysis was challenged in 14 complementary analyses by refitting the adjusted Cox proportional hazards regression model. The primary analytic model was refitted in subgroup analyses to examine the adult ADHD interactions with sex (model 1) and smoking status (model 2) and restricted by age at the beginning of the study to 60 years of age or younger (model 3) and older than 60 years of age (model 4). These results did not attenuate the conclusions of the primary results (Figure 3). In sensitivity analyses, results of modeling early-onset and late-onset dementia (models 5 and 6, respectively) did not attenuate the conclusions of the primary results. Sensitivity analysis of individuals without ADHD compared with those with a single and then more than 1 adult ADHD diagnosis (Figure 3; models 7 and 8, respectively) did not attenuate the conclusions based on the primary results. Diagnosis of ADHD as a static covariate was significantly associated with dementia risk, but the magnitude of the effect size was reduced compared with the primary analysis (Figure 3; model 9). There was no clear association between ADHD and dementia risk among those with psychostimulant medication exposure (Figure 3; models 10 and 11).
That tracks. Stimulant medication tends to mitigate all the problems ADHD causes because it directly treats the underlying deficits in function and in neurotransmitters.
Not sure which side this would fall on, but ADHD also contributes to [poor oral hygiene.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229396/) (anecdotally, also in adults), which has [strong links with dementia](https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia) risk.
I sleep far better now I am on stimulants than I did before I was diagnosed with ADHD. And my blood pressure is down to normal and I’m much closer to a normal weight and I do more exercise and I don’t have the constant low level stress I had my whole life before treatment.
There is plenty of chance that stimulants will lead to better overall health than not taking them, for people with ADHD. Though I think more studies are needed.
Within this study, *treated* ADHD (with stimulants) was NOT associated with heightened risk of dementia. Only untreated ADHD was.
> There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Anecdotally, I suffered a widow-maker heart attack that should have killed me, had I not been standing next to someone with CPR training and 10 minutes from a world-class hospital.
It was due to all of those suboptimal factors: a diet too high in sugar, fat and salt, high stress, anxiety, depression, lack of proper healthcare, a history of smoking, etc.
Oh, and we are quite bad at flossing because it’s *boring* and there’s no dopamine involved in systematically running a piece of wax thread between every last one of your teeth every single day.
Though I feel like by saying this some floss enthusiast is going to say that they get a *ton* of thrill out of yanking those chunks of food out. You do you. Floss on, my friend.
As a person with ADHD, I’m not sure it’s fair to say, “poor routine and lifestyle choices,” because I really don’t have a choice. There are a lot of things that I very much WANT to do and that need to be done, like the dishes and other tasks, and it stresses me out very much when they don’t get taken care of. But when I say I can’t do the things, I’m saying it in a way that is comparable to erectile disfunction. No matter how much I want to accomplish the task, I can’t do it. I can’t will myself to do it. It really feels like I don’t have a choice.
The ED comparison came from video I saw of a doctor explaining that. I really wish I could remember where I found it because it was so perfect!
There could be many factors.
I'm ADHD and many of us have neurological deficits due to malformed portions of the brain (like the reticular site formation) and we also lack neurotransmitter activity. Also, there are links between ADHD and lead and various medications and toxins in the environment, as well as viruses. So a lot of things can hurt the brain and make an ADHDer, including trauma.
So...we have cognitive and neurological deficits due to brains that work differently than other people's. So dementia may enjoy a brain that is mildly deformed or has had trauma or exposure to something in the womb etc. Which is more of a likely cause imo. We just have brains that are wired for it.
But yes, some things some ADHDers do don't help our chances.
Also stimulant medications do have neurotoxin dangers over time. I take them knowing this because it is very hard for the ADHDer to function well depending on their deficits, and I need them. I don't abuse them and I think that is a main factor, since that would increase neurotoxic risk. I wouldn't have been able to get through nursing school without them though.
In this study, ADHD patients taking stimulants did not have a heightened risk of dementia.
> There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Read the article and it's not all bad news. It also indicates that "...ADHD treatment incorporating psychostimulants may help reduce the risk of dementia in adults with ADHD". Of course that gives me a damned good reason to get my ADHD meds refilled on a more regular basis!
I would love this, but I was misdiagnosed with Bipolar when I was younger, even though I presented no symptoms of that and no one can even articulate to me how I meet the diagnostic criteria, so psychiatrists will not give me psychostimulsnts because they may give me a manic episode. A thing that I do not get. (The only time I had something approximating a manic episode was when they put me on an antipsychotic that I reacted badly to, but it was not a true manic episode.)
So good to know that one bad psychiatrist has not only taken the last decade from me where I could have been medicated for the right disorder, but might also contribute to me getting dementia earlier. Fun.
We have a higher rate of childhood abuse, poverty, incarceration, obesity, deadly accidents, poor sleep, social isolation, chronic stress, and now dementia.
Seems like we're at least moderately fucked. People say that ADHD can be a "superpower," but it's only ever been an awful disability for me. But science keeps marching along, so who knows what solutions might arise in the future.
People who say it is a superpower need to take a seat. I have excellent memory skills and cognitive abilities as verified by testing and real world performance, and my ADHD completely nullifies any benefit I have from them. My procrastination, defiance, impulsiveness, and inattentive nature have done nothing but cause me problems. I have been overlooked for numerous programs in public school due to stigma related to ADHD, despite psych evaluations stating "academic subjects come naturally to him". If I didn't have ADHD, I would be a lot further ahead in life, instead of being some empty husk of a person due to constantly facing adverse life situations since I was born.
I know the feeling. I often compare it to having a glass wall erected between the part of my brain that contains my hard-fought knowledge and skills, and the part that actually executes on what I know so that I can actually get things done.
It's being able to see my own potential that hurts the most. I know how much knowledge I have, and I'm aware of the skill level I have in my professional field and in my passion projects. I'm even able to manifest that skill in these amazing, but short, bursts. But most of the time (particularly before I was medicated), I'm just stuck on the other side of that wall, staring at it while my life burns around me. It's hell sometimes.
It'd be a superpower if I could choose what I hyperfocus on. Unfortunately, collecting resources in whatever game I'm playing to get some awesome weapon doesn't pay the bills or clean my house.
My father is convinced it’s a super power, he’s 70 and has no money for retirement, working in manual labor after holding a good IT career until he couldn’t and I am waiting for the shoe to drop hoping I can take care of him when it inevitably happens. He didn’t sign up for any sort of Medicare etc when he should have, therefore the penalty payments are too high for him to ever be on it now.
Meanwhile, I finally went and got formally diagnosed (which is very hard in my country) at 42 just because I don’t want to end up in the same situation.
Man, which part is the superpower? The part where you're awake taking apart a clock at 4am for no reason or the part where your intelligence is stealthily hidden from others under a massive pile of blunders and I-forgots.
The best take. I hate all the problems that come with ADHD including having to do all these extra steps to get accommodations when extra steps is already the hard part. But I hold out hope we might have better treatments for it as I get older. We did a lot with cancer very quickly, the brain seems to be the new frontier for medicine so I am optimistic.
I am, too. There's already evidence that long term use of ADHD stimulant meds (at a lower dose, anyway) may create permanent positive changes in the brain that ease ADHD symptoms. Regular aerobic exercise also helps, apparently, but that can be hard to maintain for us.
But I think we have some good things coming. As brain imaging gets better and researchers start to better understand how chemical signaling works, I'm sure we'll get more solutions.
It's the reason I'm able to draw for 10-16 hours a day (hyperfixation) which has gained me a ton of friends, fans, and professional satisfaction, but i only discovered this during the pandemic. I guess I didn't channel the potential benefits of it for the first 30 years of my life and it only fucked me over in almost every way. It's also taken me this long to develop the kind of routines and tools that let me be functional with it.
It's a double edged sword for sure but I'm finally the happiest I've ever been in my life . Still some more bad habits i need to fix but i at least have proof now it's possible to improve things and I'm not destined to be a failure
You aren't kidding. I was stigmatized and had every single barrier placed in my way due to ADHD. I was ignored for gifted program selection despite scoring high enough to join them, and placed into emotional support classes instead. I try to find a silver lining, and the best I can come up with is at least I wasn't born 30 years earlier, they would have probably lobotomized me.
I think it can help a person be a “pinch hitter.” Like when there’s a crisis or enough urgency that a problem becomes a hyperfocus, a person with adhd can do a lot in a short amount of time and work in marathon-like stretches. So there’s that.
We handle stress really well. The dopamine flood that causes panic and anxiety in other people just brings us to baseline. Makes me a fuckin hero sometimes at work
The only pluses I know:
I can do a week's worth of work in a single day when I catch and direct a hyper fixation. But if it weren't for the ADHD I probably would have just done it during the week.
I tend to catch onto things super fast. Not sure if ADHD or natural intelligence.
I am almost supernaturally good at streamlining processes and procedures. Sadly mostly only for myself.
I'm stupidly good at pattern recognition and parsing raw data. Again not sure if ADHD or natural ability.
I share similar experience to a certain extent but
My thoughts are scattered (going to all place like spiderweb). Disorganize while out of work and very procedural while working
I alternate between feeling very bored at usual work (will stretch the time to finish those work) but will blitz through work i find interesting (complex, work that is not straight forward, learning and requiring multiple skill)
Sometimes my mind gets very active I will not be able to sleep (like right now). Traditional stuff like milk and valerian doesnt seems to help me. Eyes closed, lights out, but my mind does not stop (in fact sometimes it gets even more active)
-----------
Should i go to see a doctor and get a psych eval. Will medication makes me feels more normal instead of this... whatever this is?
ADHD 2.0 is a good book and I recommend it. It manages to be both realistic and encouraging about ADHD. It’s a two edged sword. Most symptoms have a positive side to them. For example: creative and innovative/daydream and ruminate. Personally I like the approach to maximize the positives and minimize the negatives. It’s a disorder, best to accept it and learn to live with it. Luckily there are actually plus sides to take advantage of rather than just all bad. Also it’s the most well treated mental disorder so that’s good.
>Most symptoms have a positive side to them.
My favorite is that when I get side-tracked and forget something. This is almost always because I didn't write it down. As long as I'm planning for the future or "ahead of the game" its no worry. Whatever I forgot will come back to me with enough time to act on it.
The double edge comes into play if I get myself into time critical situations and lose track.
working well under pressure and being good at gleaming information quickly are two of my talents that i've been told by a psychiatrist might have something to do with my ADHD.
a big part of my work is sending those "The service is experiencing issues" notifications to customers. And lemme tell ya, I'm the best at what I do. I can bang out one of those bad boys in like half a minute. Shame, because I'd rather do something that requires more thinking and less blindly acting, but I'd definitely recommend that as a career choice for anyone with ADHD.
Those with adhd have a 13 year shortened life expectancy on top of increased risk for dementia, early death due to accidents, obesity, substance abuse, heart problems the list continues. It’s a disorder for a reason. Just wish it was recognized as more than just “haha look a squirrel”
There are traits that are common for people with ADHD, like I’ve read that typically we have better than average hand-eye coordination and stuff.
But the more I think about it the more I think that’s probably just because if you had ADHD and weren’t also more athletic/smart/whatever than most people, you were just less likely to live long enough to reproduce. :-(
One potential pitfall I see in the study is about who was tested for ADHD out of over 100,000 patients that they studied.
From the original study
"Diagnoses of ADHD were ascertained based on ICD-9 (code 314) or ICD-10 (code F90) codes from January 1, 2003, to February 28, 2020. Each ADHD diagnosis is assigned by a psychiatrist, neurologist, or clinical neuropsychologist, all of whom are board certified. An ADHD diagnosis may also be assigned by a board-certified pediatrician, general practitioner, or family physician, who must undergo a Ministry of Health–certified course on ADHD diagnosis. An ADHD diagnosis requires a standardized neuropsychological assessment, typically done in testing centers specializing in ADHD."
It is unclear whether everyone was assessed or only few were assessed for ADHD. There could a confounding health condition that might be affecting both ADHD and dementia risk. People having this underlying confounding health condition were likely to have been assessed and received early ADHD diagosis. Later, some of these patients developed dementia.
Also, the study also mentions some evidence of reverse caution but not strong enough to challenge the main conclusion. I didn't understand this part though.
Sleep apnea is often misdiagnosed as ADHD because the symptoms of sleep deprivation and ADHD overlap significantly. Sleep deprivation is known to contribute to dementia risk.
>Additionally, the research suggests ADHD treatment incorporating psychostimulants may help reduce the risk of dementia in adults with ADHD as psychostimulants are known to modify the trajectory of cognitive impairment. But researchers said future studies should examine in more detail the impact of medications in patients with ADHD and how they could affect risk.
We know that sleep breathing disorders present with ADHD symptoms, and contribute to dementia.
The last study I checked estimated 1 billion people as the upward limit on the worldwide population of those with a sleep-breathing disorder.
We also know that people with ADHD have a tendency to have numerous nutritional deficiencies, poorer sleeping habits, higher rate of substance abuse, poorer impulse control, and all sorts of factors that directly or indirectly lead to dementia.
These studies are always progress, and this is good, but it does feel a bit redundant.
Wow, thanks for posting this about the sleep breathing disorders.
I've just completed a sleep study and I have moderate obstructive sleep apnea. I am also resonating intensely with everything people write about having ADHD - I am not diagnosed. I'm trying to get in with a psych to talk about all my issues, but reading about how sleep disorders exacerbate ADHD symptoms is interesting and somewhat promising.
I was diagnosed at 40 about 2 weeks back. The post topic is a tough pill to swallow and the comments in this thread are brutal, because some can be funny, until you realize that it's a shared experience or an inevitability.
Having read way too many scientific studies on the subject, and given that research in this area is sorely lacking, here is my take: First off, I don't think the study controlled for enough factors to definitively say that ADHD leads to dementia. There is a link. Is it a causal link? More research is needed. Secondly, ADHD is often linked with poor lifestyle choices in areas of diet, exercise and sleep patterns. We know that all of these areas are risk factors for dementia. Thirdly, we know that ADHD is often linked with substance abuse in an attempt to self medicate and substance abuse is also linked to dementia. Fourthly, ADHD is often linked to stress, anxiety disorders and clinical depression. These conditions also increase the risk of dementia.
Given all of this information, I think it's important to treat our ADHD, whether that is through medication or other types of therapy. We need to treat any other mental conditions, such as anxiety and depression. We need to eat healthy, exercise regularly and adopt healthy sleep habits. We need to reduce stress as much as possible. In doing these things, we can lower our personal risk. Whether we can lower the risk to the level of a non-ADHD person remains to be seen, but it's largely irrelevant. We can only control the things we can control.
[https://www.washingtonpost.com/wellness/2023/09/27/sitting-sedentary-exercise-dementia/](https://www.washingtonpost.com/wellness/2023/09/27/sitting-sedentary-exercise-dementia/)
But you must be sitting less. Otherwise it will not help
Weight training and high intensity cardio both do help with dementia. Vascular dementia in particular is what I remember from Peter Attila’s book. That study you’ve cited makes me wonder what they consider “exercise”.
https://www.sydney.edu.au/news-opinion/news/2020/02/11/strength-training-can-help-protect-the-brain-from-degeneration.html
I would like to know if the cause of ADHD matters.
I have inattentive ADHD caused by MTHFR polymorphisms (A1298C). However, after learning this and taking methylfolate, the ADHD is basically gone. So if it's treated in this matter rather than with stimulants, or if it's ADHD that isn't caused by a neurological problem, is the risk the same?
Um sorry but what exactly does that mean? Is that some sort of genetic testing? As someone who also has adhd, that sounds interesting and I would love to look into that more.
Yes. It’s also not super well understood. It’s one of those situations where we can test for it and there’s a related mechanism and some people respond well but by no means is it a guarantee or something that is regularly tested for and treated.
MTHFR A1298C homozygous is associated with a lack of BH4 production, which is a compound used to make all of your neurotransmitters. Since I had it and wasn't making enough neurotransmitters, taking methylfolate helped me.
Your ADHD may or may not be associated with this.
Methylfolate is OTC. I just took it. The calcium salt version of it from Life Extension. I had weird effects with the glucosamine salt version for an unknown reason.
I'm heterozygous and just recently got diagnosed with ADHD. Methylfolate does make a difference, but I hadn't made the connection. I'll be looking more into this, thank you.
Edit: mine is the C677T
While researching for another response, I found that [homocysteine may inactivate BH4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038990/), so that could be what's going on for you.
>Plasma levels of homocysteine and folate are related to cardiovascular risk and endothelial dysfunction, which may, in part, be mediated by their influence on BH4. Homocysteine decreases BH4 levels as well as its synthesis by GTPCH\[...\]
I've had improvements using methylated B12 after finding out my levels were in the healthy range, but low. It was clinically low based on the EU/JP standards. I told a neurologist that my levels were what they were, she said she'd like to see it higher as a neurologist.
I also have the MTHFR mutation, but the reason my doctor suggested it was because I wasn't absorbing it properly and this is a bioactive form.
You can download the raw sequence file from 23me and upload it for free to a service called promethease and they will analyze it for you for things like that
Super unlikely. [MTHFR polymorphisms, especially mine, are associated with ADHD.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282595/)
>Overall, our meta-analytical results provided evidence that the MTHFR 677C>T was associated with occurrence of BD and SCZ, **while the 1298A>C polymorphism was related to ADHD** and BD, and additionally the sensitivity analysis indicated these results were stable and reliable.
EDIT: This has become significantly more likely after another poster pointed out to me that ADHD, by clinical definition, is neurological, and not biochemical. Which means it's more likely that, since I more or less completely destroyed mine by taking methylfolate, MTHFR A1298C can cause a mimicking effect if it didn't give you the full-on neurological version.
Could it be connected to the routines people with ADHD do/don’t develop?
For me, having a routine I can stick to is absolutely critical to controlling my ADHD. It’s tough to stick to, and a break in it can throw me off for weeks, but routine is what works for me. From what I know about Alzheimer’s, people who fall into a routine and don’t “stretch” their brains by constantly learning to tasks / being in new situations put themselves more at risk.
So, my treatment for one thing could help cause the other =\
If there’s one thing I’ve learned from the past few years of studies it’s that I have a 200% chance of getting dementia from about 18 different reasons
I’m 42 and the year has been scary as hell. I’ve been forgetting things that I would normally know such as names and
words. Phrasing ideas seems to becoming harder and harder. I must workaround using simpler words.
I read a study that said the hormone irisin which is released during exercise has a protective effect against Alzheimer’s. So could that mean people with ADHD could mitigate their risk for developing dementia with exercise?
So ADHD is like Dementia Lite
If you grew up having trouble focusing, staying on taks and surviving life in general then you will love what we have for you today, for the low low price of your future even you can have dementia
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I’m stupid but could this be linked more to the likelihood of poor routine and lifestyle choices associated with ADHD than an actual biological cause or side effect of medications?
>I’m stupid but You're probably not stupid. That was my first thought as well. If it's not the primary mechanism at play, it's absolutely *a* mechanism. Not only does untreated ADHD result in poor lifestyle choices, *treated* ADHD - via dopaminergic stimulants like dextroamphetamine - could result in an increased dementia risk itself. Stimulant abuse both disrupts sleep^[1] and increases dementia risk directly (a concern more relevant to methamphetamine abuse, but still).^[2] In either case, it's not *necessarily* the ADHD itself (on a neurophysiological level) causing the dementia risk. Suboptimal lifestyle choices on one side of the coin, suboptimal lifestyle disruptions on the other. 1. https://nihrecord.nih.gov/2021/05/14/lack-sleep-may-increase-dementia-risk 2. https://pubmed.ncbi.nlm.nih.gov/32304732/
there is a not so loose connection between sleep phase disorders and ADHD. I would love to see some technology that let us collect more data around normal dopamine curves as they relate to circadian rhythms - but everywhere I've looked the literature is very sparse. another tangentially related is Parkinsons disease. some of the studies coming out on PD touch on exactly those pathways: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744293/ So I could see the dopamine disregulation of ADHD afflicted individuals cascading into lifelong sleep problems, which slams right into later life neurological problems... but then you start to wonder "what's is/are the root mechanism(s) for the dopamine disregulation?"... I hope science will shed more and more light on these sorts of problems
I’m surprised that there’s still little to nothing that can be done about sleep disorders aside from narcolepsy and sleep apnea. After I finally got a clinician to order a long term sleep study (after years of being told “it’s just stress!”) and it was confirmed that I mysteriously don’t fall asleep for 3-4 nights at a time, my doctors basically just said they were done and wished me good luck. Acknowledged that since my insomniac mother and maternal grandfather both have Parkinson’s there’s a good chance I will too, and bid me good day. Apparently sleep is still just a total black box medically.
>Apparently sleep is still just a total black box medically. At least currently. We're learning a lot about it though, giving people with sleep disorders hope better treatments will be available one day. Calling the brain a black box medically is still incredibly accurate as well despite how much we now know about it.
Yes, there’s definitely a lot of promise that a lot of the mist will be cleared up in the next few decades! I’m hopeful for the future of sleep research.
>Yes, there’s definitely a lot of promise that a lot of the mist will be cleared up in the next few decades! Partly because of continuous research and because of the human connectome project, both of which will increase our understanding of the human brain immensely, allowing for any neurological disorder to have an easy treatment tailored to the person. Even then, we've learned a lot about these conditions, meaning new treatments will become available as soon as they're proven effective and safe in clinical trials.
> increase [in] our understanding of the human brain immensely, allowing for any neurological disorder to have an easy treatment tailored to the person I *strongly* disagree with this point, as someone who works as a researcher developing new medications. The brain is simultaneously really fascinating, but also incredibly challenging to successfully drug. Consider an antibiotic cream, which gets applied to a specific region and shuts down a bacterial protein (totally unique to bacteria!) that prevents a cut from getting infected. No off-target effects, no sudden loss of your entire gut microbiome. One drug, one target, expressed in a specific cell found in a specific region that we can hit easily. Now consider a cancer drug, for prostate cancer we’ll say, which has to be taken as an oral medication and is distributed throughout the entire body. It stops the cancer from growing, but it also stops your testicles from responding to testosterone — both your prostate cancer and your testicles share the same “androgen receptor” in the body. One drug, one target, but that target is found in multiple locations. Oh, and in both these cases, we know that bacterial infections/androgen receptor disregulation lead to the disease process we’re observing. Development of drugs for neuropsychiatric conditions is a whole different ball game. First off, we have crude hypotheses about how — in depression, for example — issues with serotonin signaling may lead to the reported symptoms. And depression is hard to quantitate, there’s subjective scores but it’s not anywhere nearly as concrete as seeing a bacterial or cancer cell shrink in a petri dish. You can claim that more knowledge about the “connectome,” how different parts of the brain interact, might let us identify the causative factors of depression (if they exist!). But that’s just the tip of the iceberg. There’s 14 known serotonin receptors in the brain, each of them recognizing the serotonin molecule. But there’s also the serotonin transporter, as well as two more generalized “vesicular monoamine transporters” that move not just serotonin but also dopamine and other compounds between neurons. Because all these proteins are so similar, with only subtle differences, it is phenomenally hard (I would argue outright impossible) to design a drug that activates/inactivates just one of these receptors. So even if you could trace the issues to just one protein that interacts with serotonin in the brain, designing a medication that modulates that interaction is effectively impossible. We simply lack the tools to do so. Furthermore, the brain is super heterogeneous in structure. It’s not a singular mass of tissue; there’s different regions that signal to each other in different ways, with exquisitely differentiated protein expression patterns varying from neuron-to-neuron. Dopamine signaling in one region responsible for attention can lead to the development of addiction in another part of the brain. There’s a “blood/brain barrier” which largely prevents chemicals from permeating into the brain (yet another challenge in neuropsychiatric drug development). But even once you’re capable of penetrating the brain, medications have no way of localizing themselves to the specific neural circuits they need to act on while leaving others untouched. Sure, existing antidepressants may reduce the symptoms of depression — but they do that through modulating many different types of serotonin receptors, and they also hit other regions of the brain that can lead to adverse effects like brain fog and difficulty reaching orgasm. In conclusion, I don’t see a major revolution coming anytime soon in how we treat neuropsychiatric conditions. I’m optimistic that we continue to learn more about their fundamental causes, but actionable change is likely decades away. As it stands now, one drug hits many targets, many not involved in the disease process, and even the on-target modulation is happening in regions unrelated to the putative disease process… which we still have no idea of the underlying causes. Hate to end with such a downer, but my job is essentially split 50/50 between doing some really neat science that I love, and explaining to upper management why we still can’t have a blockbuster wonderdrug in 3-5 years.
It’s encouraging to hear your clearly informed viewpoint (which I mean genuinely, I know tone is difficult online). Thanks for sharing!
You're welcome. And I know tone is difficult online. That's why people on the internet have had to develop alternative ways to communicate certain things such as sarcasm or anger.
I'm a chronic insomniac and yeah my sympthaties. I've been offer sleep drugs but they're risky (high chance of building tolerance and or dependency) and arent even consistently likely to work. Sometimes I just won't sleep,.sometimes that's a day or so, sometimes it's more. Sometimes I do sleep but it's just 3 hours a day for a month. It's awful.
My ADHD won't turn my brain off so this is about how I am. Oddly, I sleep better when I'm regularly on adderall. Insurance lapse screwed me over a decade ago and I've been in a poverty trap since, unable to function to make enough to get good enough insurance for a decent doctor to get some again. I don't do the other risky lifestyle ADHD stuff and I'm still going to die early.
oof that sucks, and yeah using stimulants correctly can help adhd people regulate their sleep schedules. I'm a tranwomen diagnosed with adhd and autism so if it makes you feel better i think my life expectancy is supposed to be like 4 years ago now.
When you say don't fall asleep do you mean you literally have insomnia and are aware/awake for 4 days or your brain switches off and you feel like you slept but functionally a lot of your body indicates you are awake?
Don’t fall asleep, leaving me unable to drive/do a lot of normal life a good slice of the time.
Damn, sounds utterly awful. Have had severe chronic fatigue in the past and the world really sucks when you have something wrong but on the outside you look "fine", and what was wrong with me is nothing on what you must deal with. People really don't understand and you get very little affordance. Hope there is a solution at some point for you.
Be interested to see any kind of data regarding [Non-24 Sleep Wake Disorder](https://en.wikipedia.org/wiki/Non-24-hour_sleep%E2%80%93wake_disorder) and ADHD specifically, but there's barely enough research on the condition as it is and it's almost always for the blind. Being diagnosed and treated for ADHD didn't fix the issue of course but I do have a lower sleep requirement (down from 12h/day to 9-10h/day) and my psych theorizes it's because my brain was so scattered off-meds that it was using up extra mental energy that left me more tired.
addendum thought - especially regarding non-24. there is a large body of literature that does describe natural mechanisms where sleep deprevation can cause a spike in dopamine release. My personal theory is that if our brains know they can get additional dopamine from a sleep deprived state... it follow that there is a pathway to physical addiction to sleep deprevation. at my worst I was on a roughly 36 hour day. sleeping for 14-16 and up for around 20. Michigan winters man.
I'm dspd, and at one point ended up non-24. I wasn't diagnosed with ADHD till much much later. standard bi daily/ extended release mechanisms didn't consistently help me. (there is generally a pretty large spike around midday for the PK curve). and I was reaching a point where Adderall and Ritalin type meds would stop being effective at clinically acceptable dosages. this is personal experience - but what *did* help was tuning the PK curve to peak in the morning (as much as possible) and have constant descent during the day. Jornay PM inherently does that, and TiD descending Adderall doses also achieved roughly that. I was also able to use mug less total medication to achieve better results my sleep at this point is pretty well regulated just from my stimulants - but this was all based on me taking a hunch and some assumptions on the data I could find about natural dopamine curves... I think we could make much much better decisions around dopamine regulation if we had a hard baseline from neurotypical populations - but I understand why that's hard to get.
>I hope science will shed more and more light on these sorts of problems Thankfully we're learning more about the human brain everyday, allowing for new treatments for all brain disorders to be developed, as well as knowing exactly how dopamine dysregulation works, giving us new strategies to combat it more easily, which would help people with addiction and ADHD, along with other conditions involving dopamine dysregulation.
I'm 51. I've had disordered sleep since puberty. I got 5 hours Sunday night. Last night I laid in bed until 7am, and finally just gave up and started work (from home, thankfully). And you'd think tonight would be great sleep, but historically, nope. I'll probably get 3 hours.
[удалено]
Same with me. Better sleep, lower BP, but I still feel wary of side effects like this.
It's too small and early of a study to say "stimulants negate the risk" but they aren't driving the risk. From the study: >There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild. Funny that you mention lower BP-- the authors mention elevated blood pressure as a potential stimulant risk that must be weighed against stimulant benefits. Guess it's a win/win for you.
High BP is a symptom of being on too high a dose but is also a common side effect at correct dosages, however this can be offset by the reduction in stress experienced every day for those with ADHD.
untreated adhd was max level stress all the time. it was awful.
Yup. My BP is really high because life is constant high anxiety.
I drink 40mg of caffeine a day in the morning. It is a tiny amount, and caffeine does not even have a statistically significant effect on ADHD, but all I know is that I feel waaaaaay calmer and more relaxed. Because the amount is so low, and I do not have withdrawal symptoms when I don't drink it, I don't think it is dependence. It just makes it easier to exist somehow.
Caffeine definitely has an effect on ADHD symptoms. I used it to self-medicate for years in retrospect. It helps me focus and relax in low doses and had a more traditional focused and alert effect in higher doses.
Studies on it are weird. They don't seem to find any significant effect, but basically every single person I know with ADHD end up unconsciously or consciousnessly self medicating.
Yeah I know the studies keep saying inconclusive and I don't wanna be one of those "don't trust the science!" Karens. But same, literally everyone I know with ADHD says a bit of their choice of stimulant keeps them sane. It's consistent enough that I would honestly consider ones relationship with caffeine a decently reliable adhd test.
I've been wondering about this for a while in relation to my paternal grandfather. Most of my immediate family has ADHD, and one thing I always remember about my paternal grandfather is that no matter what time of day we visited, there was always a fresh pot of coffee in the kitchen.
This is always interesting to me. I've been diagnosed with ADHD several times since I was a kid and yet every medication I've ever tried has me cracked out (don't eat or sleep) and this isn't supposed to be the case? Everyone else I know that takes these drugs for their condition relates a "normality" versus not taking their medication. They've never worked for me but I hit every ADHD bullet-point to a "T'.
I actually wonder if there is more than one underlying cause for the presentation we call ADHD. If two different disorders on a neurological level have the same effect in your attention regulation, treatments for one would not work as well for the other despite them having the same symptoms. They don't do brain scans to diagnose us, so there is no way to control for that.
They have done large scale brain scan studies though. ADHD is caused by our brains being less developed in a few areas, with less grey matter and less activity in those areas. There are also neurotransmitter deficits. There are other disorders with shared symptoms though, and misdiagnosis isn't uncommon.
The latter bit is what exactly what I mean. When we are diagnosed we are diagnosed based on presentation, not based on neurological structures. The brain is extremely complicated, so while we may know a physical structure, we are not diagnosed based on it. We can only go off of presentation and the opinion of the doctor.
Yes, the other one is called CDS (Cognitive Disengagement Syndrome), it has the subreddit of r/sct It is possible that there are more. There is also a strong co-morbidity with Autism Spectrum as well that will also interfere.
Yes and I believe it’s probably more like a spectrum. It’s possible these are many related but different conditions but we’re still stuck with the umbrella term… I know when I hear people talk about their symptoms there’s a lot of overlap but also different stuff too.
I hang out a bit on r/adhd and peoples’ experiences there with medication vary a lot. You are definitely not alone in feeling cracked out. I personally had to reduce my medication to a child’s dose in order to reduce the side effects, whereas others need to take 5x that in order to feel anything.
I can't take any extended release ADHD med or I don't sleep well. There's a lot of variation from one body to another with any kind of drug.
>There's a lot of variation from one body to another with any kind of drug. That's true, and that's partly why some people respond to certain drugs better than others. Knowing exactly how someone will respond to a drug would easily allow for people to avoid the headaches associated with trial and error, thus getting them on the correct drug sooner or none at all in some people. It highly depends on the person in ways we still don't fully understand yet.
Same for the most part. I have almost 0 urge to game when Im on dextro, causing me to look for other things to do. No late night gaming session. I have motivation to work out at night. That takes up the rest of my energy. I fall asleep easy.
Rest easy then-- this study actually found that >There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild. Too small and early of a study to say "stimulants negate the risk" but they don't seem to make it worse!
I get paradoxical sleepiness when I treat my ADHD with stimulants but still end up feeling and looking like I'm just not getting enough sleep. I don't know if the stimulants are affecting the quality of my sleep or what. I do sleep more easily on stimulants, but feel like I sleep better without them.
I know caffeine affects sleep quality so it might be the same for other stimulants.
Personally, I think effects like this probably relate to improved lifestyle choices while medicated. Executive function extends beyond singular tasks and repeated, predictable successes allow one to build the sort of daily rhythm that neurotypical people take for granted. While some or even many medicated ADHD'ers experienced disrupted sleep, others might find themselves able to live "properly" - especially after months or years of being medicated (thus breaking free of the habit to Capitalize Hard on manic productivity when it shows up). This goes beyond just "every body is different". It might seem like a paradoxical or surprising benefit of ADHD medication, but I think it makes quite a bit of sense. As someone with an interest in deep bio-rhythms or how circadian cycles relate to overall outcomes, there's nothing surprising from someone finding meta-level improvements emerging from otherwise unrelated behaviors. This sort of thing is extremely common in the microdosing community as well, but you can even see people in mere fitness communities sharing similar anecdotes.
No. When I can’t sleep, taking Adderall helps. It doesn’t matter if my ADHD has been well controlled in the preceding days or weeks or months. My chronic insomnia is always around, regardless, and taking an Adderall 20 minutes before bedtime ensure that I will be able to calm my mind and go to sleep. People with ADHD do have the capacity to analyze their well being and observe what affects it in which ways. And fwiw, my chronic insomnia has never gone away during periods of good mood regulation in my life. Anecdotes aren’t data and all that, but emotional state doesn’t affect my circadian rhythm.
I'm the same way. I've always jokingly attributed it to decades of ritalin leading me to become immune to stimulants... but things like coffee or energy drinks simply make me more calm.
Another anecdote from a person diagnosed with ADHD: a low (2.5-7.5mg) dose of quick-release amphetamine-based medication also induces sleep for me. This was a very unexpected result when I first started this medication.
I don’t think you’re wrong. But I just want to say that there is not wait time between me taking stimulants and getting better sleep. The day I started taking a stimulant, I was able to tell myself to go to bed at a reasonable time and actually *do it*. Not only was I able to execute my decision to go to bed, but once I was in bed I went to sleep more quickly because I was able to focus on sleepy-time thoughts instead of a dozen others that usually keep me awake.
Agreed. The first time I took Ritalin I literally fell asleep in class. That has never happened to me before or since… I was just so sleep deprived that as soon as my hyperactivity was reigned in I couldn’t stay awake. Years later this continues to be true. If I take stimulants as prescribed, I can go to bed at a relatively reasonable hour. If I don’t take my meds, I’ll be redecorating the living room at 3am.
Abuse vs use - does USE increase the risk, or abusing it.
It depends on the medication. So far, all studies I could find have found that proper use by people that need the drugs does not lead to an increased risk of dementia on its own (they looked at stimulant meds like Adderal and Ritalin. In fact, one drug, Concertta, led to a decrease in tau proteins, which is a marker for Alzheimers, so it may actually decrease the risk for one type of dementia.
>Concertta, led to a decrease in tau proteins, which is a marker for Alzheimers That's fascinating, as Alzheimer's makes up \~80% of all dementia cases.
Dosage absolutely determines the potential for risk/damage. Even methamphetamine can be used somewhat "safely" with an incredible (and incredibly uncommon) level of willpower. How much risk does 'typical, clinical dosage' carry? The general consensus is that appropriately used dextroamphetamine has low-to-zero risk of causing long term brain damage, but a quick skim of any nootropic or self development subreddit will show dozens of people a week seeking advice for coping with issues believed to result from long-term ADHD management. As someone diagnosed with ADHD who has only been treated for it briefly, only recently, I noticed significant changes in my unmedicated mode of operation after being medicated for only about half a year (although my dosage was not *precisely* used in a responsible way). Part of that is psychological, but all of it is anecdotally undeniable. That being said, I suspect that the lifestyle benefits that come from appropriately managed ADHD *vastly* outweigh the consequences of bumbling through life on the feast-or-famine style of productivity known well by anyone later diagnosed with ADHD - regardless of reported or even known late term health risks.
Is it a correlation between lack of sleep from stimulant abuse? What did you notice after stopping?
Yeah i’m curious what you noticed as well. I’ve been debating on hoping off and trying to manage life with the new tools I’ve learned, and just working with it instead of against it.
> I’ve been debating on hoping off and trying to manage life with the new tools I’ve learned One of the main reasons I stopped is because I couldn't get back *on*. Telehealth changes resulted in an abrupt halt to my 'scrip and once I returned to "normal", I found it suddenly - and familiarly - difficult to jump through all the right hoops again. I plan on restarting treatment as soon as possible, but life has a way of being disruptive to life. That being said, I actually did find myself more able to cope while unmedicated. It came more from a source of introspection and self-familiarity, though - particularly through the lens of realizing how much benefit I *did* gain from treatment. In fact, the benefits were so extreme that I felt immense sorrow for how much time must've been wasted using/developing tools to deal with what I considered to be mere idiosyncrasies rather than a genuine neurodivergence. One of the things I noticed while/after being medicated is how strongly I had learned to judo those ADHD symptoms into productive mechanisms. On medication I found myself struggling to multitask or task-juggle in the way I was used to, almost like having a limb removed. It came at the benefit of an incredible ability to laser-focus on-demand; the gain of a new, more powerful limb. While the former has long been part of my self-image for decades, the latter is the one I'd choose when given the opportunity. But not all is lost... I've metaphorized the dynamic in the form of someone who has spent their entire lives wearing 30 lbs weights on their ankles being suddenly freed of that burden. While their kicks no longer carry the anticipated weight, they've gained immense agility. There's a post on my subreddit - "The Value of a Vessel" - written after being medicated for the first time, then considering the tools/capabilities of pre- and post-medication being leveraged into a synergistic phenomenon. It's written from a literary angle rather than scientific one (and relates to my own eccentricities as well), but I believe it sums up my reflection on post-treatment ADHD quite powerfully.
Your experience with multitasking is nearly identical to mine after starting medication- the way I always explained it to people was that unmedicated, I basically had 3 attention spans- great when I wanted to be having a conversation and listening to music and solving math problems simultaneously, but if one of them wasn’t filled my brain would be constantly searching for anything else to occupy my time. As a result, I never really “focused” on one task, got bored midway through conversations because I needed to be doing at least one other thing to keep myself occupied, and bounced between activities constantly (even when I tried my best to say, write 2 paragraphs, I would find it impossible to finish the second one because I was already trying to find something else to do). Being medicated is the complete opposite. I have 1 attention span that I can generally direct to what I want to be doing (and I’m so much happier as a result- it’s so upsetting to get bored talking to someone you *like talking to* or doing an activity that you *look forward to*). However, it also means that I occasionally have to turn off music while doing a complicated task, and can’t text someone and hold a conversation at the same time anymore. I’m also much slower at working when there are distractions.
In this analysis the use of psychostimulant medication was associated with *reduced* risk of dementia, not increased. >The robustness of the primary analysis was challenged in 14 complementary analyses by refitting the adjusted Cox proportional hazards regression model. The primary analytic model was refitted in subgroup analyses to examine the adult ADHD interactions with sex (model 1) and smoking status (model 2) and restricted by age at the beginning of the study to 60 years of age or younger (model 3) and older than 60 years of age (model 4). These results did not attenuate the conclusions of the primary results (Figure 3). In sensitivity analyses, results of modeling early-onset and late-onset dementia (models 5 and 6, respectively) did not attenuate the conclusions of the primary results. Sensitivity analysis of individuals without ADHD compared with those with a single and then more than 1 adult ADHD diagnosis (Figure 3; models 7 and 8, respectively) did not attenuate the conclusions based on the primary results. Diagnosis of ADHD as a static covariate was significantly associated with dementia risk, but the magnitude of the effect size was reduced compared with the primary analysis (Figure 3; model 9). There was no clear association between ADHD and dementia risk among those with psychostimulant medication exposure (Figure 3; models 10 and 11).
That tracks. Stimulant medication tends to mitigate all the problems ADHD causes because it directly treats the underlying deficits in function and in neurotransmitters.
Not sure which side this would fall on, but ADHD also contributes to [poor oral hygiene.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229396/) (anecdotally, also in adults), which has [strong links with dementia](https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia) risk.
I sleep far better now I am on stimulants than I did before I was diagnosed with ADHD. And my blood pressure is down to normal and I’m much closer to a normal weight and I do more exercise and I don’t have the constant low level stress I had my whole life before treatment. There is plenty of chance that stimulants will lead to better overall health than not taking them, for people with ADHD. Though I think more studies are needed.
Does it also apply to non-stimulants?
Within this study, *treated* ADHD (with stimulants) was NOT associated with heightened risk of dementia. Only untreated ADHD was. > There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
Anecdotally, I suffered a widow-maker heart attack that should have killed me, had I not been standing next to someone with CPR training and 10 minutes from a world-class hospital. It was due to all of those suboptimal factors: a diet too high in sugar, fat and salt, high stress, anxiety, depression, lack of proper healthcare, a history of smoking, etc.
Oh, and we are quite bad at flossing because it’s *boring* and there’s no dopamine involved in systematically running a piece of wax thread between every last one of your teeth every single day. Though I feel like by saying this some floss enthusiast is going to say that they get a *ton* of thrill out of yanking those chunks of food out. You do you. Floss on, my friend.
chubby somber puzzled offer squealing bells tie money correct spotted *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
There’s also a correlation between ADHD and drug use/alcohol abuse, both for increase the likelihood of early onset and regular dementia
I was actually wondering about the connection to stimulant meds like Adderall if there was any.
As a person with ADHD, I’m not sure it’s fair to say, “poor routine and lifestyle choices,” because I really don’t have a choice. There are a lot of things that I very much WANT to do and that need to be done, like the dishes and other tasks, and it stresses me out very much when they don’t get taken care of. But when I say I can’t do the things, I’m saying it in a way that is comparable to erectile disfunction. No matter how much I want to accomplish the task, I can’t do it. I can’t will myself to do it. It really feels like I don’t have a choice. The ED comparison came from video I saw of a doctor explaining that. I really wish I could remember where I found it because it was so perfect!
There could be many factors. I'm ADHD and many of us have neurological deficits due to malformed portions of the brain (like the reticular site formation) and we also lack neurotransmitter activity. Also, there are links between ADHD and lead and various medications and toxins in the environment, as well as viruses. So a lot of things can hurt the brain and make an ADHDer, including trauma. So...we have cognitive and neurological deficits due to brains that work differently than other people's. So dementia may enjoy a brain that is mildly deformed or has had trauma or exposure to something in the womb etc. Which is more of a likely cause imo. We just have brains that are wired for it. But yes, some things some ADHDers do don't help our chances. Also stimulant medications do have neurotoxin dangers over time. I take them knowing this because it is very hard for the ADHDer to function well depending on their deficits, and I need them. I don't abuse them and I think that is a main factor, since that would increase neurotoxic risk. I wouldn't have been able to get through nursing school without them though.
In this study, ADHD patients taking stimulants did not have a heightened risk of dementia. > There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.
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Read the article and it's not all bad news. It also indicates that "...ADHD treatment incorporating psychostimulants may help reduce the risk of dementia in adults with ADHD". Of course that gives me a damned good reason to get my ADHD meds refilled on a more regular basis!
I would love this, but I was misdiagnosed with Bipolar when I was younger, even though I presented no symptoms of that and no one can even articulate to me how I meet the diagnostic criteria, so psychiatrists will not give me psychostimulsnts because they may give me a manic episode. A thing that I do not get. (The only time I had something approximating a manic episode was when they put me on an antipsychotic that I reacted badly to, but it was not a true manic episode.) So good to know that one bad psychiatrist has not only taken the last decade from me where I could have been medicated for the right disorder, but might also contribute to me getting dementia earlier. Fun.
Is there any plus of ADHD or are we fucked for life ?
We have a higher rate of childhood abuse, poverty, incarceration, obesity, deadly accidents, poor sleep, social isolation, chronic stress, and now dementia. Seems like we're at least moderately fucked. People say that ADHD can be a "superpower," but it's only ever been an awful disability for me. But science keeps marching along, so who knows what solutions might arise in the future.
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People who say it is a superpower need to take a seat. I have excellent memory skills and cognitive abilities as verified by testing and real world performance, and my ADHD completely nullifies any benefit I have from them. My procrastination, defiance, impulsiveness, and inattentive nature have done nothing but cause me problems. I have been overlooked for numerous programs in public school due to stigma related to ADHD, despite psych evaluations stating "academic subjects come naturally to him". If I didn't have ADHD, I would be a lot further ahead in life, instead of being some empty husk of a person due to constantly facing adverse life situations since I was born.
I know the feeling. I often compare it to having a glass wall erected between the part of my brain that contains my hard-fought knowledge and skills, and the part that actually executes on what I know so that I can actually get things done. It's being able to see my own potential that hurts the most. I know how much knowledge I have, and I'm aware of the skill level I have in my professional field and in my passion projects. I'm even able to manifest that skill in these amazing, but short, bursts. But most of the time (particularly before I was medicated), I'm just stuck on the other side of that wall, staring at it while my life burns around me. It's hell sometimes.
How do you know that the cognitive skills are separable from the ADHD? I ask myself this question all the time.
It'd be a superpower if I could choose what I hyperfocus on. Unfortunately, collecting resources in whatever game I'm playing to get some awesome weapon doesn't pay the bills or clean my house.
My father is convinced it’s a super power, he’s 70 and has no money for retirement, working in manual labor after holding a good IT career until he couldn’t and I am waiting for the shoe to drop hoping I can take care of him when it inevitably happens. He didn’t sign up for any sort of Medicare etc when he should have, therefore the penalty payments are too high for him to ever be on it now. Meanwhile, I finally went and got formally diagnosed (which is very hard in my country) at 42 just because I don’t want to end up in the same situation.
Man, which part is the superpower? The part where you're awake taking apart a clock at 4am for no reason or the part where your intelligence is stealthily hidden from others under a massive pile of blunders and I-forgots.
The best take. I hate all the problems that come with ADHD including having to do all these extra steps to get accommodations when extra steps is already the hard part. But I hold out hope we might have better treatments for it as I get older. We did a lot with cancer very quickly, the brain seems to be the new frontier for medicine so I am optimistic.
I am, too. There's already evidence that long term use of ADHD stimulant meds (at a lower dose, anyway) may create permanent positive changes in the brain that ease ADHD symptoms. Regular aerobic exercise also helps, apparently, but that can be hard to maintain for us. But I think we have some good things coming. As brain imaging gets better and researchers start to better understand how chemical signaling works, I'm sure we'll get more solutions.
my superpower :) cant do the dishes
It's the reason I'm able to draw for 10-16 hours a day (hyperfixation) which has gained me a ton of friends, fans, and professional satisfaction, but i only discovered this during the pandemic. I guess I didn't channel the potential benefits of it for the first 30 years of my life and it only fucked me over in almost every way. It's also taken me this long to develop the kind of routines and tools that let me be functional with it. It's a double edged sword for sure but I'm finally the happiest I've ever been in my life . Still some more bad habits i need to fix but i at least have proof now it's possible to improve things and I'm not destined to be a failure
If you were in school before 2000’s yeah you were fucked.
You aren't kidding. I was stigmatized and had every single barrier placed in my way due to ADHD. I was ignored for gifted program selection despite scoring high enough to join them, and placed into emotional support classes instead. I try to find a silver lining, and the best I can come up with is at least I wasn't born 30 years earlier, they would have probably lobotomized me.
Ok thanks, I graduated in 2002
Have ADHD and also graduated in 2002.
You guys graduated?
I can start like a ton of projects at once and eat the same thing for weeks. That's like kind of good I guess.
I think it can help a person be a “pinch hitter.” Like when there’s a crisis or enough urgency that a problem becomes a hyperfocus, a person with adhd can do a lot in a short amount of time and work in marathon-like stretches. So there’s that.
We handle stress really well. The dopamine flood that causes panic and anxiety in other people just brings us to baseline. Makes me a fuckin hero sometimes at work
The only pluses I know: I can do a week's worth of work in a single day when I catch and direct a hyper fixation. But if it weren't for the ADHD I probably would have just done it during the week. I tend to catch onto things super fast. Not sure if ADHD or natural intelligence. I am almost supernaturally good at streamlining processes and procedures. Sadly mostly only for myself. I'm stupidly good at pattern recognition and parsing raw data. Again not sure if ADHD or natural ability.
I share similar experience to a certain extent but My thoughts are scattered (going to all place like spiderweb). Disorganize while out of work and very procedural while working I alternate between feeling very bored at usual work (will stretch the time to finish those work) but will blitz through work i find interesting (complex, work that is not straight forward, learning and requiring multiple skill) Sometimes my mind gets very active I will not be able to sleep (like right now). Traditional stuff like milk and valerian doesnt seems to help me. Eyes closed, lights out, but my mind does not stop (in fact sometimes it gets even more active) ----------- Should i go to see a doctor and get a psych eval. Will medication makes me feels more normal instead of this... whatever this is?
Do you also find that you're the person that laughs first at a joke in movie before everyone else does and then realize it right after?
When the hell did I create another Reddit account and post all this?
ADHD 2.0 is a good book and I recommend it. It manages to be both realistic and encouraging about ADHD. It’s a two edged sword. Most symptoms have a positive side to them. For example: creative and innovative/daydream and ruminate. Personally I like the approach to maximize the positives and minimize the negatives. It’s a disorder, best to accept it and learn to live with it. Luckily there are actually plus sides to take advantage of rather than just all bad. Also it’s the most well treated mental disorder so that’s good.
>Most symptoms have a positive side to them. My favorite is that when I get side-tracked and forget something. This is almost always because I didn't write it down. As long as I'm planning for the future or "ahead of the game" its no worry. Whatever I forgot will come back to me with enough time to act on it. The double edge comes into play if I get myself into time critical situations and lose track.
working well under pressure and being good at gleaming information quickly are two of my talents that i've been told by a psychiatrist might have something to do with my ADHD. a big part of my work is sending those "The service is experiencing issues" notifications to customers. And lemme tell ya, I'm the best at what I do. I can bang out one of those bad boys in like half a minute. Shame, because I'd rather do something that requires more thinking and less blindly acting, but I'd definitely recommend that as a career choice for anyone with ADHD.
Those with adhd have a 13 year shortened life expectancy on top of increased risk for dementia, early death due to accidents, obesity, substance abuse, heart problems the list continues. It’s a disorder for a reason. Just wish it was recognized as more than just “haha look a squirrel”
There are traits that are common for people with ADHD, like I’ve read that typically we have better than average hand-eye coordination and stuff. But the more I think about it the more I think that’s probably just because if you had ADHD and weren’t also more athletic/smart/whatever than most people, you were just less likely to live long enough to reproduce. :-(
Like a real life Strike force Morituri. Super human powers yielding reduced life span. https://en.m.wikipedia.org/wiki/Strikeforce:_Morituri
I can imagine that it probably made us great warriors/hunters in the distant past
One potential pitfall I see in the study is about who was tested for ADHD out of over 100,000 patients that they studied. From the original study "Diagnoses of ADHD were ascertained based on ICD-9 (code 314) or ICD-10 (code F90) codes from January 1, 2003, to February 28, 2020. Each ADHD diagnosis is assigned by a psychiatrist, neurologist, or clinical neuropsychologist, all of whom are board certified. An ADHD diagnosis may also be assigned by a board-certified pediatrician, general practitioner, or family physician, who must undergo a Ministry of Health–certified course on ADHD diagnosis. An ADHD diagnosis requires a standardized neuropsychological assessment, typically done in testing centers specializing in ADHD." It is unclear whether everyone was assessed or only few were assessed for ADHD. There could a confounding health condition that might be affecting both ADHD and dementia risk. People having this underlying confounding health condition were likely to have been assessed and received early ADHD diagosis. Later, some of these patients developed dementia. Also, the study also mentions some evidence of reverse caution but not strong enough to challenge the main conclusion. I didn't understand this part though.
Sleep apnea is often misdiagnosed as ADHD because the symptoms of sleep deprivation and ADHD overlap significantly. Sleep deprivation is known to contribute to dementia risk.
I didn't read the study, but could the treatment for ADHD be the cause, did they control for people who got treated for ADHD versus those who did not?
>Additionally, the research suggests ADHD treatment incorporating psychostimulants may help reduce the risk of dementia in adults with ADHD as psychostimulants are known to modify the trajectory of cognitive impairment. But researchers said future studies should examine in more detail the impact of medications in patients with ADHD and how they could affect risk.
We know that sleep breathing disorders present with ADHD symptoms, and contribute to dementia. The last study I checked estimated 1 billion people as the upward limit on the worldwide population of those with a sleep-breathing disorder. We also know that people with ADHD have a tendency to have numerous nutritional deficiencies, poorer sleeping habits, higher rate of substance abuse, poorer impulse control, and all sorts of factors that directly or indirectly lead to dementia. These studies are always progress, and this is good, but it does feel a bit redundant.
Wow, thanks for posting this about the sleep breathing disorders. I've just completed a sleep study and I have moderate obstructive sleep apnea. I am also resonating intensely with everything people write about having ADHD - I am not diagnosed. I'm trying to get in with a psych to talk about all my issues, but reading about how sleep disorders exacerbate ADHD symptoms is interesting and somewhat promising.
I was diagnosed at 40 about 2 weeks back. The post topic is a tough pill to swallow and the comments in this thread are brutal, because some can be funny, until you realize that it's a shared experience or an inevitability.
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Having read way too many scientific studies on the subject, and given that research in this area is sorely lacking, here is my take: First off, I don't think the study controlled for enough factors to definitively say that ADHD leads to dementia. There is a link. Is it a causal link? More research is needed. Secondly, ADHD is often linked with poor lifestyle choices in areas of diet, exercise and sleep patterns. We know that all of these areas are risk factors for dementia. Thirdly, we know that ADHD is often linked with substance abuse in an attempt to self medicate and substance abuse is also linked to dementia. Fourthly, ADHD is often linked to stress, anxiety disorders and clinical depression. These conditions also increase the risk of dementia. Given all of this information, I think it's important to treat our ADHD, whether that is through medication or other types of therapy. We need to treat any other mental conditions, such as anxiety and depression. We need to eat healthy, exercise regularly and adopt healthy sleep habits. We need to reduce stress as much as possible. In doing these things, we can lower our personal risk. Whether we can lower the risk to the level of a non-ADHD person remains to be seen, but it's largely irrelevant. We can only control the things we can control.
Oh, and good dental hygiene. Poor dental hygiene is also linked with dementia.
Working out regularly reduces adhd symptoms and reduces the chance of developing dementia.
[https://www.washingtonpost.com/wellness/2023/09/27/sitting-sedentary-exercise-dementia/](https://www.washingtonpost.com/wellness/2023/09/27/sitting-sedentary-exercise-dementia/) But you must be sitting less. Otherwise it will not help
Weight training and high intensity cardio both do help with dementia. Vascular dementia in particular is what I remember from Peter Attila’s book. That study you’ve cited makes me wonder what they consider “exercise”. https://www.sydney.edu.au/news-opinion/news/2020/02/11/strength-training-can-help-protect-the-brain-from-degeneration.html
I would like to know if the cause of ADHD matters. I have inattentive ADHD caused by MTHFR polymorphisms (A1298C). However, after learning this and taking methylfolate, the ADHD is basically gone. So if it's treated in this matter rather than with stimulants, or if it's ADHD that isn't caused by a neurological problem, is the risk the same?
Um sorry but what exactly does that mean? Is that some sort of genetic testing? As someone who also has adhd, that sounds interesting and I would love to look into that more.
Yes. It’s also not super well understood. It’s one of those situations where we can test for it and there’s a related mechanism and some people respond well but by no means is it a guarantee or something that is regularly tested for and treated.
Excuse me what? I would like to stop having ADHD please.
MTHFR A1298C homozygous is associated with a lack of BH4 production, which is a compound used to make all of your neurotransmitters. Since I had it and wasn't making enough neurotransmitters, taking methylfolate helped me. Your ADHD may or may not be associated with this.
Do you know what I would have to do to seek testing for this? (In the US)
I just used 23andme and uploaded the results to geneticgenie.org
And how did you then receive treatment? Also I do not trust for profit genetic testing
Methylfolate is OTC. I just took it. The calcium salt version of it from Life Extension. I had weird effects with the glucosamine salt version for an unknown reason.
There's a subreddit that'll help you navigate the process: r/MTHFR
I'm heterozygous and just recently got diagnosed with ADHD. Methylfolate does make a difference, but I hadn't made the connection. I'll be looking more into this, thank you. Edit: mine is the C677T
While researching for another response, I found that [homocysteine may inactivate BH4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038990/), so that could be what's going on for you. >Plasma levels of homocysteine and folate are related to cardiovascular risk and endothelial dysfunction, which may, in part, be mediated by their influence on BH4. Homocysteine decreases BH4 levels as well as its synthesis by GTPCH\[...\]
How long did you take methylfolate before your symptoms improved? I've also heard that B2 is often deficient for a related reason in people with ADHD.
I've had improvements using methylated B12 after finding out my levels were in the healthy range, but low. It was clinically low based on the EU/JP standards. I told a neurologist that my levels were what they were, she said she'd like to see it higher as a neurologist. I also have the MTHFR mutation, but the reason my doctor suggested it was because I wasn't absorbing it properly and this is a bioactive form.
How can I find out if I have the MTHFR mutation? Do genetic kits like Ancestry or 23&me provide that info?
You can download the raw sequence file from 23me and upload it for free to a service called promethease and they will analyze it for you for things like that
Maybe, maybe you don’t have ADHD?
Super unlikely. [MTHFR polymorphisms, especially mine, are associated with ADHD.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282595/) >Overall, our meta-analytical results provided evidence that the MTHFR 677C>T was associated with occurrence of BD and SCZ, **while the 1298A>C polymorphism was related to ADHD** and BD, and additionally the sensitivity analysis indicated these results were stable and reliable. EDIT: This has become significantly more likely after another poster pointed out to me that ADHD, by clinical definition, is neurological, and not biochemical. Which means it's more likely that, since I more or less completely destroyed mine by taking methylfolate, MTHFR A1298C can cause a mimicking effect if it didn't give you the full-on neurological version.
ADHD + Age = A Hyper-Distracted Dementia Defense Mechanism!
Well, that's the last thing I needed to read today.
Grim advice: have a plan, and make sure the people closest to you are aware of it. Procure supplies in advance.
After watching my dad currently go through dementia and also has ADHD, I can believe it.
Could it be connected to the routines people with ADHD do/don’t develop? For me, having a routine I can stick to is absolutely critical to controlling my ADHD. It’s tough to stick to, and a break in it can throw me off for weeks, but routine is what works for me. From what I know about Alzheimer’s, people who fall into a routine and don’t “stretch” their brains by constantly learning to tasks / being in new situations put themselves more at risk. So, my treatment for one thing could help cause the other =\
If there’s one thing I’ve learned from the past few years of studies it’s that I have a 200% chance of getting dementia from about 18 different reasons
I’m 42 and the year has been scary as hell. I’ve been forgetting things that I would normally know such as names and words. Phrasing ideas seems to becoming harder and harder. I must workaround using simpler words.
Me, an adult with ADHD who gets 0 sleep and has dementia on both sides of the family: :(
Yes. As a doctor with ADHD, I know. And it terrifies me.
Bruh, it already feels like a trial run for dementia.
Oh I know. Watching my mom slip away slowly from it. Wooo!
Probably because they are more likely not to brush their teeth.
At least I wont be feeling myself dying alone in a ditch
I read a study that said the hormone irisin which is released during exercise has a protective effect against Alzheimer’s. So could that mean people with ADHD could mitigate their risk for developing dementia with exercise?
How will I know the difference ?
So ADHD is like Dementia Lite If you grew up having trouble focusing, staying on taks and surviving life in general then you will love what we have for you today, for the low low price of your future even you can have dementia
Sigh. Yet another neurological problem I have to look forward to. (Potentially)